N3C in Action

November 2023

N3C Data Identify Drugs That May Boost Risk of Post–COVID-19 Pulmonary Fibrosis

A new study used NCATS’ N3C database to see how more than 450,000 people without pulmonary fibrosis (PF) fared after they were hospitalized with COVID-19. Researchers looked at how common drugs linked to PF affected the risk of developing post–COVID-19 PF. Rituximab and chemotherapy drugs were tied to greater PF post-infection risk. In patients exposed to rituximab, PF incidence was 2.8 cases per 100 person-years, compared with 1.1 cases per 100 person-years in a control group. PF incidence among those exposed to chemotherapy was 2.2 cases per 100 person-years, compared with 1.3 cases among a control group. The heart drug amiodarone did not appear to boost risk. Learn more about this study and potentially modifiable risk factors for PF after having COVID-19.

February 2023

NIH RECOVER Research Identifies Potential Long COVID Disparities

A study used electronic health record data from the N3C Data Enclave to examine patterns of more than 30,000 people diagnosed with long COVID. Researchers found that most patients in the study were White, female, non-Hispanic and likely to live in areas with low poverty and greater access to health care, suggesting that not all patients who have long COVID are being diagnosed. Learn more about the study.

October 2022

N3C Effort to Speed COVID-19 Public Health Answers

NCATS has launched a new effort to deliver fast, actionable analyses on pressing COVID-19 questions. The effort is called N3C Public Health Answers to Speed Tractable Results (PHASTR). It will leverage N3C’s collection of clinical data representing more than 16 million anonymized individuals.

NCATS will post a series of timely questions about COVID-19 health outcomes that currently are not studied within the N3C. Individuals or teams then can submit proposals on how they would use the N3C Data Enclave to answer specific questions. The initial questions look at whether earlier findings on reinfection and long-term neurologic disorders among mostly white males are similar to findings from N3C’s more demographically diverse data set. NCATS will publish results from the analyses on the N3C Public Health Dashboards and disseminate them to public health officials. See more details, including FAQs. N3C PHASTR also is funded by the NIH National Institute of General Medical Sciences.

N3C Data Reveal COVID-19 Hospitalization Increases Risk of Heart Failure

Using data from more than half a million electronic health records in the N3C Data Enclave, researchers found that a greater percentage of people who had been hospitalized with COVID-19 developed heart failure than people who had been hospitalized without COVID-19. Learn more about this study.

September 2022

Researchers Use N3C Data to Analyze Rural Versus Urban COVID-19 Hospitalization Rates

Using electronic health records in the N3C Data Enclave, researchers discovered health disparities in COVID-19-related hospitalizations in rural communities compared to urban communities of the United States. The N3C allowed researchers to examine these findings more in-depth than in a traditional population-based study. Learn more about this research study and findings.

May 2022

Study Finds Immune Dysfunction Is a Significant Risk Factor for COVID-19 Breakthrough Infection

Researchers used data from the N3C Data Enclave to identify a link between COVID-19 breakthrough infections and compromised immune systems, including in individuals living with HIV or receiving immunosuppressant medications. A breakthrough infection is an infection that happens at least 14 days after full vaccination. The study also highlighted the importance of people staying up to date with vaccinations and providers recommending other risk-reduction steps. Learn more about the study.

Scientists Identify Characteristics to Better Define Long COVID

Long COVID is a condition marked by wide-ranging symptoms, including shortness of breath, fatigue, fever, headaches, “brain fog” and other neurological problems. Such symptoms can last for months or longer after an initial COVID-19 diagnosis. To get a better understanding of long COVID and the individuals who are likely to have it, NIH-supported researchers used machine learning techniques to analyze an unprecedented collection of de-identified electronic health records in NCATS’ N3C Data Enclave. Read the full news release.

Researchers Use Cutting-Edge EHR Data Resource to Find Risk Factors for Severe COVID-19 in Children

Using data from NCATS’ N3C Data Enclave, researchers studied electronic health records from more than 1 million patients ages 18 and younger who were tested for SARS-CoV-2. Of those children who tested positive, some developed a dangerous condition called multisystem inflammatory syndrome in children (MIS-C), in which some organs become inflamed. NCATS-supported researchers were able to find risk factors for the children with MIS-C. Doctors can account for these risk factors when making medical decisions. If pediatricians know which patients are most at risk, they can give those patients more aggressive treatments to prevent hospitalization and harm from COVID-19. Read the article.

March 2022

N3C Study Ties Aspirin Use in Moderate COVID-19 to Lower Risk of Blood Clots and Death

Giving aspirin to people hospitalized with moderate COVID-19 may reduce their risks of blood clots in the lung and of death, according to a large study of patient information from the N3C Data Enclave. Researchers examined health records from a racially and ethnically diverse group of 112,269 people in the United States with moderate COVID-19 that required a hospital stay. They compared people who didn’t receive aspirin when they entered the hospital with those who did. Patients given aspirin were 29% less likely to have a pulmonary embolism, in which a blood clot blocks an artery in the lung, and 14% less likely to die over the next 4 weeks. The reduced risks were most apparent in people given aspirin who were older than 60 years or who had at least one medical condition other than COVID-19. Learn more about the N3C-based findings on aspirin.

February 2022

N3C Reveals COVID‑19 Hospitalization and Death Risks Among People with Type 2 Diabetes

The N3C database has helped reveal that blood sugar levels may predict which people with type 2 diabetes and acute COVID‑19 infection are at greater risk of hospitalization or death. Researchers examined N3C patient health records to track outcomes for a diverse population of more than 39,000 people across the United States. Overall, they found that among people whose hemoglobin A1c levels — a measure of blood sugar — were above 7%, there were increased rates of hospitalization, ventilator use and death. Higher blood sugar levels posed a much greater risk of death for people who were Hispanic or Latino than for those who were Black or African American, white, Asian American, or Pacific Islander. Because people with diabetes can monitor their own hemoglobin A1c levels at home, they could use these measurements to better predict their own risks for COVID‑19 complications. Learn more about the N3C‑driven study findings.

August 2021

N3C Database Reveals Increased COVID‑19 Mortality Risk in People with COPD

Results from an N3C study showed that people with chronic obstructive pulmonary disease (COPD) were more likely to be hospitalized and die of COVID‑19 than people without COPD. Researchers examined patient records in the N3C Data Enclave.

The researchers reviewed data from thousands of people who tested positive for COVID‑19 and had COPD. They compared these data with data from people who tested positive but did not have COPD. COPD is the most common chronic lung disease in the United States. It includes such conditions as emphysema and bronchitis. COPD disproportionately affects women and older adults.

September 2020

Using Existing Partnerships to Build a National COVID‑19 Data Analytics Platform

Investigators have collected huge amounts of COVID‑19 data, but accessing and combining that data in a useful way is challenging. To solve this problem, NCATS partnered with the CTSA Program institutions, the CD2H, and more than 70 research institutions to develop a centralized national data resource for COVID‑19 data: the N3C Data Enclave.

The N3C has information from more than 4.9 million diverse patients with COVID‑19. That information is accessible through the N3C Cohort Explorer. The secure database helps researchers conduct studies related to COVID‑19 infection. More than 300 research projects are currently using N3C data.

The researchers evaluated N3C data for trends. The data included vaccination status, COVID‑19 diagnoses, immune dysfunction diagnoses, comorbid conditions and demographics data. The N3C enclave is one of the largest collections of COVID‑19 clinical data in the United States. It was critical to this research effort. The data enclave eliminated the need for testing centers and widespread recruitment efforts. Such research components, among others, can pose challenges to studies.